On Friday, Michigan Gov. Rick Snyder (R) signed a strict Medicaid work requirement passed by the state’s GOP-controlled legislature. Under the new law, Michigan will join the dozen states who are actively seeking or have already received a waiver from the Trump administration to implement the new rules — which are expected to drop hundreds of thousands of people from the Medicaid rolls.
Michigan’s bill was significantly rewritten after the first version came under fire for having a significant racially disparate impact. Under the original proposal, people living in counties with unemployment rates above 8.5 percent would have been exempt from the work requirement. Those counties were overwhelmingly white, rural, and Republican. Low-income residents of color in Detroit and Flint, where the joblessness and poverty are extremely high, would not have received an exemption, because the wealthier suburbs surrounding those cities pulled the overall county unemployment rate below the threshold.
The blowback to that plan prompted Michigan lawmakers to make revisions, including the elimination of any exemptions for people in places where it is difficult to find a job.
“They can avoid the disparate impact by leveling up or leveling down, and they chose to level down,” Nicholas Bagley, a law professor at the University of Michigan who specializes in health policy, told TPM. “They could have chosen to extend the same solicitude they had for people in rural areas with high unemployment to people in cities with high unemployment, but did not do so. I think it speaks to how punitive this law will be for many people. You’re telling people to find work where there is no work to be had.”
The revised law requires adult Medicaid enrollees who do not have a disability to work at least 20 hours per week in order to maintain their insurance. If they cannot find a job, they can complete community service to fulfill the requirement, but only for three months each year.
More than half a million people in Michigan would be subject to the new requirements, and as many as 54,000 people could lose their coverage as a result.
And if the Trump administration were to deny Michigan’s request for a waiver to implement the work requirement, or if a court were to strike them down as illegal under the Medicaid statute, the state is threatening to roll back their Medicaid expansion.